Adult unilateral duplex system ureterocele with multiple calculi

Ureterocele is a congenital cystic dilatation of the distal portion of the ureter. A was admitted to our hospital with complaints of pollakuria, right flank pain and macroscopic hematuria. Direct urinary system X-ray suggested a right lower ureteral calculi and intravenous pyelography (IVP) revealed a right side complete duplex system of ureterocele, multiple distal ureteral calculi and characteristic appereance of "cobra head" or ''spring onion''. A transurethral transversal incision was made in the right ureterocele at the inferior lateral border and 176 spherical calculi of almost the same size were removed. In conclusion, endoscopic ureterocele incision and stone extraction is a safe and effective treatment of adult orthotopic ureteroceles and this technique has minimal risk for iatrogenic vesicoureteral reflux.